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Can a Pill Make You Smarter?

Several drugs can improve thinking, memory, and alertness in people with Alzheimer's disease and other diseases that affect the mind. So can these drugs help healthy people, too?
By Martin F. Downs
WebMD Feature

The drive to self-improvement is one of the defining aspects of our culture. We are willing to go to great lengths to match our ideals; and if you're not an Adonis or Venus, a mental equal to Einstein, or the spiritual equivalent of a saint, you may have felt a twinge of shame and pressure to whip yourself into shape.

So it's no surprise that as soon as medical science develops a treatment for a disease, we often ask if it couldn't perhaps make a healthy person even healthier. Take Viagra, for example: developed to help men who couldn't get erections, it's now used by many who function perfectly well without a pill but who hope it will make them exceptionally virile.

The same thing is happening with psychopharmaceuticals -- drugs that work on the mind. Ritalin, the first drug to treat attention deficit hyperactivity disorder, has been widely used by normal students hoping to be extra sharp while taking SATs or cramming for college exams.

Several new medications are on the market and in development for Alzheimer's disease, a progressive neurological disease leading to memory loss, language deterioration, and confusion that afflicts about 4.5 million Americans and is expected to strike millions more as the baby boom generation ages. Yet the burning question for those who aren't staring directly into the face of Alzheimer's is whether these medications might make us smarter.

'Flogging Your Nerves'

Memory loss, as well as dementia, is a key feature of Alzheimer's disease. If medications to treat Alzheimer's can improve memory, why shouldn't they help healthy people, too?

In theory, it's possible, says Marvin Hausman, MD, CEO of Axonyx Inc., a company whose Alzheimer's drug Phenserine is undergoing clinical trials in Europe. Phenserine is not available in the U.S.

Phenserine, as well as the drugs Aricept and Exelon, which are already on the market, work by increasing the level of acetylcholine, a neurotransmitter that is deficient in people with the disease. A neurotransmitter is a chemical that allows communication between nerve cells in the brain. In people with Alzheimer's disease, many brain cells have died, so the hope is to get the most out of those that remain by flooding the brain with acetylcholine.

"If you start flogging your nerves in an indiscriminate fashion, you're going to increase both short-term and long-term memory," Hausman says.

Yet there is no proof that an Alzheimer's drug could improve brain function in healthy people, although the results of one tantalizing study conducted by Stanford University researchers showed that a small group of middle-aged pilots given Aricept did better on flight simulation tests compared with those given a placebo.

Hausman hastens to add that his company has no interest in developing Phenserine as a "smart drug," for use in normal people. "I don't know if the FDA would ever allow a normal memory drug," he says.

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